Economic costs are commonly
cited as barriers to women's use of antiretroviral therapy (ART) in sub-Saharan
Africa; however, little is known about how changes in women's income influence
economic barriers to care. We analysed in-depth interviews with 17 HIV-positive women who participated in a job-creation programme
in northern Uganda and two key informant interviews with programme staff to
examine lingering economic barriers to care experienced after programme
enrolment.
We found that participants continued to experience economic barriers
even after receiving a steady income and improving their economic status. Two
themes emerged:
- first, limited resources in health facilities (e.g. drug and staff shortages) led participants to view ART utilisation as a primarily economic endeavour where clients made informal payments for prompter service or sought treatment in private facilities where ART was readily available;
- second, increased economic status among participants increased expectations of economic reciprocity among participants' social networks.
Job-creation programmes should consider how health institutions interact with
participants' financial obligations to influence women's access to HIV services.
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- 1 Department of Health and Behavioral Sciences , University of Colorado Denver , Denver , USA.
- 2 31Bits International , Costa Mesa , USA.
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